KA CHUN YIP, Presenter: Nothing to Disclose

YU CHING LAU, Abstract Co-Author: Nothing to Disclose

Sirong Chen, Abstract Co-Author: Nothing to Disclose

William Cheung, Abstract Co-Author: Nothing to Disclose

Chi Lai Ho, Abstract Co-Author: Nothing to Disclose

Upright (U) and supine (S) positions for myocardial perfusion imaging (MPI) are routinely performed on a CZT solid state cardiac scanner with variable angle capacity. It is based on the assumption that diaphragmatic attenuation artifacts are normalized or shifted in location at different positions to differentiate from true perfusion defects. We aim to evaluate if a single semi-supine (SS) position with lumbar support could minimize these artifacts and have a diagnostic accuracy comparable to a U&S MPI.

36 patients (M=32, mean age=65±12y, mean BMI=25.3±4.1) suspected of coronary artery disease (CAD) underwent same day Tc-99m tetrofosmin rest-stress MPI on a CZT solid state cardiac scanner (D-SPECT, Spectrum Dynamics) in 3 positions: U, S & SS (40° with lumbar support, detector head reclining), all with 1 M left ventricular coned counts. Reconstructed images by standard algorithms were individually interpreted by 2 experienced NM physicians in consensus for discriminating perfusion abnormalities from inferoapical (IA) or inferior wall (IW) artifacts. All patients had invasive coronary angiography (ICA) within 3 months after MPI, with>70% luminal stenosis as positive.

ICA confirmed 34 patients with CAD. The patient-based sensitivity and accuracy of SS MPI were 85% (29/34) and 83% (30/36), respectively, similar to those for combined U&S MPI (sensitivity 85%, accuracy 86%). 12/36 (33%, mean BMI=28.4±5.8) patients had IA artifacts on U MPI but all were partially or completely normalized on SS images. 7/36 (19%) large patients with BMI 25.4 - 44.8 showed fixed and mild IW artifacts on SS MPI significantly less severe than those on S MPI.

Single SS MPI with lumbar support could minimize IA and IW artifacts commonly appeared on U and S MPI. It has sensitivity and accuracy comparable to a 2-position U&S MPI for detection of CAD by D-SPECT.

Pre-acquisition optimization to improve raw data signal reception is as important as post-acquisition data processing. This may also improve imaging time and patient through-put.

YIP, K, LAU, Y, Chen, S, Cheung, W, Ho, C, Comparison in Diagnostic Performance between Single Semi-supine Acquisition and 2-position (Upright and Supine) Acquisition in Myocardial Perfusion Imaging with a Solid State Dedicated Cardiac Scanner.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012392.html